Basic Information
Provider Information | |||||||||
NPI: | 1316278401 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ZHANG | ||||||||
FirstName: | PAN | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.P.T | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 524 AGNEW RD | ||||||||
Address2: |   | ||||||||
City: | GREENSBURG | ||||||||
State: | PA | ||||||||
PostalCode: | 156019701 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7245527270 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 120 LYTTON AVE | ||||||||
Address2: | SUITE 275 | ||||||||
City: | PITTSBURGH | ||||||||
State: | PA | ||||||||
PostalCode: | 152131481 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4126215430 | ||||||||
FaxNumber: | 4126215460 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/29/2010 | ||||||||
LastUpdateDate: | 01/29/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | PT020384 | PA | Y |   | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.